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Dear CaDeN follower/partisan de ReCaD,

Welcome to the spring 2016 newsletter for the Canadian Deprescribing Network (CaDeN). Spring is a time for shaking off the cold winter and embracing new beginnings. This is certainly the case for CaDeN, which was officially launched on January 28th, 2016. 

Browse the newsletter below to find out what CaDeN can do for you, and about our Deprescribing Fair in January, the subsequent media interviews, our new website and tools and resources for you to download.

Our website deprescribing.org/caden/ was launched on the 19th of March. During the first two weeks we received over 1400 hits!

There is a wealth of information for patients and caregivers, clinicians, educators and researchers. Resources are freely available for downloading, including deprescribing information pamphlets for patients and deprescribing algorithms for clinicians. If you haven’t seen the new website yet, check it out here.

Second National Stakeholders Meeting

The Second National Stakeholders Meeting to Improve Safe and Appropriate Medical Therapy for Older Men and Women across Canada was held in Toronto at the end of January. The meeting brought together patient advocates, clinicians, researchers and decision-makers from across Canada. The goals of the fair included sharing best practices for deprescribing, and investigating ways and means to advance deprescribing initiatives across Canada.

Chris Power, CEO, Canadian Patient Safety Institute provided an inspiring keynote presentation on how to transform current practices. Chris highlighted the importance of patient engagement and empowerment.

A panel discussion was held to provide tips on how to achieve deprescribing among community-dwelling seniors, providing an excellent introduction to the small discussion groups. These groups focused on:

  • What role can consumers and patient organizations play in deprescribing?
    (hint: distribute our brochures to raise awareness)
  • How can you make deprescribing a priority in your clinic?
    (hint: start by identifying potentially inappropriate prescriptions)
  • How to champion a demonstration project in your organization or province?
    (hint: cite the CFHI's pilot project in Manitoba which improved quality and reduced costs
  • How to promote non-pharmacological treatments?
    (hint: check out approaches to sleeping without drugs at Sleepwell Nova Scotia
  • Policy advocacy – what is our role?
    (hint: anyone can start a campaign - see the National Pensioners Federation example)

An overview of the 2nd National Stakeholders Meeting can be found at the Canadian Institutes for Health Research (CIHR) website. Photos of the day can be seen here.

Deprescribing Fair

A deprescribing fair was held during the breaks of the 2nd National Stakeholders Meeting. The fair provided an interactive way for participants to learn more about deprescribing and non-drug alternatives.

We would like to congratulate Mike Cass for guessing the number of jellybeans in the jar. There were 1156 jellybeans, representing the 1,156,000 Canadians aged >65 years who are prescribed potentially inappropriate medications each year.  

Dorothea Talsma flew in all the way from Yukon, to win a T-shirt generously donated by Keith White from The Shared Care Polypharmacy Risk Reduction in the Elderly Initiative.

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Do you know someone who might be interested in deprescribing?

If so, we’d love to hear from them. While we began as a group of researchers, we are quickly building a network of patients, clinicians, researchers and decision-makers with a shared vision of improving medication appropriateness across Canada.

We realise you may be part of a group or an organisation that shares an interest in deprescribing. Please forward this newsletter to your friends and colleagues and invite them to join our mailing list, by clicking on the following link.

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CaDeN in the Media

The Canadian Institute for Health Information (CIHI) released a report on the use of antipsychotics in long term care facilities in February (see report here ). The Core Executive Committee of CaDeN seized the opportunity and simultaneously released a media pitch about CaDeN. What followed was a couple of busy weeks, with several of the executive committee members being involved with countless interviews for TV, radio and press.

See our very own Dr James Silvius and Dr Barbara Farrell on morning TV, discussing the creation of CaDeN.

André Picard from The Globe and Mail wrote a fantastic article called “Seniors are given so many drugs, it’s madness”. His column already has over 3000 likes on facebook.

Jennifer Zelmer, Editor in chief of Healthcare Policy, flagged our meeting and the deprescribing movement in her editorial "De-prescribing: When Less Is More in Healthcare" 

A summary of other media relating to CaDeN can be found on our website.

Choosing Wisely Canada and the deprescribing movement

The National Choosing Wisely Canada Conference was held in Toronto on the 30th of March, where they released their updated website.   

Choosing Wisely Canada's campaign is to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures. Deprescribing is an integral part of this campaign. There were two breakout sessions on deprescribing where CaDeN members Dr Barbara Farrell, Dr James Conklin and Phillipe Martin presented their research.

CaDeN logo

Do you have creative skills? Are you interested in sharing them with us?

We have received several emails since the Deprescribing Fair asking us what the CaDeN logo looks like. The short answer is we don’t have one… yet!

We need your help to design a logo for CaDeN.

It should encompass the theme of deprescribing across Canada, it must be bilingual, and should be reproducible as a small black and white logo, or as a larger color logo.

The best entry as voted by the judging panel will win a "Keep calm and stop some pills" T-shirt kindly donated by The Shared Care Polypharmacy Risk Reduction in the Elderly Initiative. In addition, the winning entry will be professionally reproduced by a graphic designer and used by CaDeN.

Send your ideas to Justin.Turner@criugm.qc.ca with "CaDeN logo" in the subject. The deadline for entries is May 13th.

Deprescribing Aphorisms, Slogans and Sound Bites

A good marketing campaign requires a good logo, and good aphorisms to hook people's attention.

Aphorisms can be used to help explain deprescribing to members of the public, clinicians, researchers and in policy communications. We would like to thank Dr David Gardner, Dr Duncan Robertson, Dr Barbara Farrell and Johanna Trimble for the following examples of aphorisms:

  • Medications. Less isn’t always better but often it’s way better.
  • You know what makes me feel good about my doctor?
    It’s when she stops meds I don’t need.
  • It’s spring! Time to declutter you medication list.
  • Medications are not meant to be a life sentence.
  • With few exceptions, a medication that is started should also be stopped.
  • Medication downsizing, it’s the latest thing.
  • A good doctor knows when to fold. Deprescribe!
  • Taking more pills than you have health problems? There’s no pill for that.
  • When the med don’t work... ‘nuff said!
  • Reducing medications safely to meet life’s changes.
  • If it won’t be missed, strike it from the list.
  • Sometimes the best medicine is less medicine .

CaDeN would like to create a library of aphorisms to post on deprescribing.org/caden/ to make it easier to discuss the importance of deprescribing.

Please email any aphorisms you have to Justin.Turner@criugm.qc.ca with the subject “CaDeN Aphorism.” Aphorisms should be 20 words or less, ideally less than 10.

Spreading the word

We are constantly looking for new avenues to facilitate the discussion between patients/caregivers, health care providers and decision-makers around deprescribing of unnecessary or harmful medications. If you know of any community groups that would be interested in hearing from us, please let us know.

As an example of what can be achieved when we collaborate with community organisations, see the National Pensioners Federation call to action here.

CaDeN is a group of clinicians, researchers, patients and patient advocates with an interest in promoting appropriate medication use across Canada.

CaDeN is committed to reducing the use of inappropriate medications by Canadian men and women over the age of 65 who live in Canada by 50% by 2020.

This initiative has been funded by a Partnership for
Health System Improvement Grant from CIHR, focused on interventions in primary care.
CaDeN Executive Committee
(L-R): Johanna Trimble, Janet Currie, Marie-Therese Lussier, Barbara Farrell,
Cara Tannenbaum, James Silvius, Steve Morgan 
Cara Tannenbaum 
on behalf of the CaDeN Executive Committee

Principal Investigator, CIHR Partnerships for Health System Improvement Grant
Michel Saucier Endowed Chair, Geriatric Pharmacology, Health and Aging
Université de Montréal
You are receiving this newsletter because
a) you attended one of the National Stakeholders Meetings or
b) you recently contacted us through deprescribing.org to be informed about deprescribing research in Canada, or
c) you have requested to receive news about the OPEN Deprescribing Guidelines project in the past. 

We are now introducing the new Canadian Deprescribing Network (CaDeN) newsletter.
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